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Objective: The purpose of study is to evaluate the recurrence rate of pelvic organ prolapse after surgical treatment and pre- to postoperative changes in sexual function of patients with different stages of pelvic organ prolapse., Methods: The presented study was a single-centre observational nonrandomized analysis of an ongoing prospective cohort study evaluating anatomical and clinical outcomes in reproductive aged women scheduled for nature tissue repair of POP staged I-III. Two hundred and ten women were recruited, of whom 120 (57.1%) had the advanced prolapse form (POP-Q III). Women at preoperative POP stage I-II were compared with women at stage III without apical prolapse., Results: The best effectively rate with low recurrence depends on preoperative prolapse stage. The overall objective success rate was about 80% in five years in patients with preoperative stage I-II. Study shows a significant improvement in sexual function in all patients with pelvic organ prolapse in five years after surgery., Conclusion: This study showed that women with advanced POP have a higher risk of recurrence after POP native tissue repair compared with early stages and proved the improvement of sexual function especially in women with advanced prolapse forms. Women with early stage of POP should be advised to postpone surgery until progression of complaints because of the high recurrence risk., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: The goal of this study was to evaluate the outcome of Tension-free Vaginal Tape Obturator (TVT-O) operation in the treatment of urodynamic stress incontinence (USI) in obese females, with respect to uroflowmetric changes, success rate and postoperative complications., Methods: This prospective observational study included 26 patients with USI at the Obstetrics & Gynecology department-Cairo University hospital during the year 2015. The participants had body mass index (BMI)≥30. Patients underwent TVT-O operation. Follow up of the patients was performed by cough test and uroflowmetry after one week, one month, three months and six months. Postoperative complications such as groin pain, sense of incomplete emptying, need to strain to complete micturition and urinary tract infection were recorded. Comparisons between groups were done using Chi square, Phi-Cramer test for categorical variables., Results: The mean age for the subjects was 43.58±9.01years. The mean BMI was 33.4±2.1. The success rate of TVT-O operation was 21 out of 26 patients (≈81%). Normal maximum flow rate was in 88% of patients at week one and was normal in 100% of patients at months three and six (p=0.101 & 0.101). Postoperative groin pain was the main complaint during the first week after operation and decreased significantly from week one to the 1st month postoperative (84.62% & 65.38%, P=0.041)., Conclusion: TVT-O operation showed a high success rate in treatment of USI in obese patients without affecting the voiding function of the bladder as proven by the uroflowmetry. The main postoperative complaint was the groin pain which significantly improved after one month., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: A survey was conducted to evaluate the urogynecology training of German gynecologists and the diagnostic tests and therapeutic options offered to women with incontinence or prolapse in hospital departments and private practices., Study Design: Questionnaires were mailed to 3000 gynecologists in private practice and to 500 consultants in gynecology departments. The questionnaire included items on urogynecological training, diagnostic workup as well as conservative and surgical treatment options., Results: The response rate was 16.8% with 589 of the 3500 questionnaires being returned. Less than one third of the respondents (28.6%) regard their training in urogynecology as good, 41% rate their training as moderate and 30.4% state that their urogynecology training during residency was inadequate. Male physicians significantly more often consider themselves well trained than women (p=.00006). The majority of gynecologists in private practice (74.7%) refer patients to a gynecological clinic for assessment of urogynecologic symptoms, 37.7% refer their patients to urologists in private practice, 10.4% to other gynecologists in private practice, and 10.4% to a urological clinic (percentages add up to more than 100% because multiple answers were allowed). Among the gynecologists who offer surgery, 81.2% perform retropubic TVT-operation and 80.1% colposuspension. Seventy-seven percentage of the gynecologists in private practice who do operations on an inpatient basis still perform anterior colporrhaphy to treat stress urinary incontinence compared to 62% of consultants in gynecological clinics (p<.05)., Conclusion: One third of German gynecologists consider themselves inadequately trained in urogynecology. The results of our survey show that there is a need for improved general training during residency and for subspecialist training.